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The use of bluetooth low energy Beacon systems to estimate indirect personal exposure to household air pollution

Journal of Exposure Science & Environmental Epidemiology volume 30, pages 990–1000 (2020)Cite this article

A Correction to this article was published on 27 February 2020

Abstract

Household air pollution (HAP) generated from solid fuel combustion is a major health risk. Direct measurement of exposure to HAP is burdensome and challenging, particularly for children. In a pilot study of the Household Air Pollution Intervention Network (HAPIN) trial in rural Guatemala, we evaluated an indirect exposure assessment method that employs fixed continuous PM2.5 monitors, Bluetooth signal receivers in multiple microenvironments (kitchen, sleeping area and outdoor patio), and a wearable signal emitter to track an individual’s time within those microenvironments. Over a four-month period, we measured microenvironmental locations and reconstructed indirect PM2.5 exposures for women and children during two 24-h periods before and two periods after a liquefied petroleum gas (LPG) stove and fuel intervention delivered to 20 households cooking with woodstoves. Women wore personal PM2.5 monitors to compare direct with indirect exposure measurements. Indirect exposure measurements had high correlation with direct measurements (n = 62, Spearman ρ = 0.83, PM2.5 concentration range: 5–528 µg/m3). Indirect exposure had better agreement with direct exposure measurements (bias: −17 µg/m3) than did kitchen area measurements (bias: −89 µg/m3). Our findings demonstrate that indirect exposure reconstruction is a feasible approach to estimate personal exposure when direct assessment is not possible.

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Acknowledgements

This study was supported through the National Heart, Lung, and Blood Institute/National Institutes of Health [1UM1HL134590-01] and Bill & Melinda Gates Foundation [OPP1131279]. A multidisciplinary, independent Data and Safety Monitoring Board (DSMB) appointed by the National Heart, Lung, and Blood Institute (NHLBI) monitors the quality of the data and protects the safety of patients enrolled in the HAPIN trial. NHLBI DSMB: Nancy R. Cook, Sc.D.; Stephen Hecht, Ph.D.; Catherine Karr, M.D., Ph.D.; Katie H. Kavounis, M.P.H.; Dong-Yun Kim, Ph.D.; Joseph Millum, Ph.D.; Lora A. Reineck, M.D., M.S.; Nalini Sathiakumar, M.D., Dr.P.H.; Paul K. Whelton, M.D.; Gail G. Weinmann, M.D. Program Coordination: Gail Rodgers, M.D., Bill & Melinda Gates Foundation; Claudia L. Thompson, Ph.D. National Institute of Environmental Health Science (NIEHS); Mark J. Parascandola, Ph.D., M.P.H., National Cancer Institute (NCI); Danuta M. Krotoski, Ph.D., Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); Joshua P. Rosenthal, Ph.D. Fogarty International Center (FIC), Conception R. Nierras, Ph.D. NIH Office of Strategic Coordination Common Fund; Antonello Punturieri, M.D., Ph.D. and Barry S. Schmetter, National Heart, Lung, and Blood Institute (NHLBI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or Bill & Melinda Gates Foundation.

HAPIN investigators:

Vigneswari Aravindalochanan10, Kalpana Balakrishnan10, Dana Boyd Barr1, Vanessa Burrowes11, Devan Campbell7, Julia McPeek Campbell1, Adly Castañaza2, Howard Chang12, Yunyun Chen12, Marilú Chiang13, Rachel Craik14, Mary Crocker15, Victor Davila-Roman16, Lisa de las Fuentes16, Ephrem Dusabimana17, Lisa Elon12, Juan Gabriel Espinoza13, Irma Sayury Pineda Fuentes2, Sarada Garg10, Dina Goodman11, Savannah Gupton1, Stella Hartinger18, Steven Harvey19, Mayari Hengstermann20, Phabiola Herrera21, Shakir Hossen11, Penelope Howards12, Lindsay Jaacks22, Shirin Jabbarzadeh12, Abigail Jones7, Miles Kirby1, Jacob Kremer7, Margaret Laws11, Amy Lovvorn1, Fiona Majorin23, Eric McCollum11, Rachel Meyers16, J. Jaime Miranda24, Lawrence Moulton25, Krishnendu Mukhopadhyay10, Abidan Nambajimana17, Florien Ndagijimana17, Azhar Nizam12, Jean de Dieu Ntivuguruzwa17, Aris Papageorghiou14, Naveen Puttaswamy10, Elisa Puzzolo26, Ashlinn Quinn27, Sarah Rajkumar5, Usha Ramakrishnan12, Davis Reardon7, Ghislaine Rosa23, Joshua Rosenthal27, P. Barry Ryan1, Zoe Sakas23, Sankar Sambandam10, Jeremy Sarnat1, Suzanne Simkovich11, Sheela Sinharoy1, Kirk R. Smith6, Damien Swearing1, Gurusamy Thangavel10, Ashley Toenjes16, Lindsay Underhill11, Jean Damascene Uwizeyimana17, Viviane Valdes12, Amit Verma12, Lance Waller12, Megan Warnock12, Kendra Williams11, Wenlu Ye1, Bonnie Young5

Author information

Authors and Affiliations

  1. Department of Environmental Health, Emory University, Atlanta, GA, USA

    Jiawen Liao, Lisa Thompson, Kyle Steenland, Thomas F. Clasen, Dana Boyd Barr, Julia McPeek Campbell, Savannah Gupton, Miles Kirby, Amy Lovvorn, P. Barry Ryan, Jeremy Sarnat, Sheela Sinharoy, Damien Swearing & Wenlu Ye

  2. Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala

    John P. McCracken, Erick Mollinedo, Eduardo Canuz, Oscar De Léon, Anaité Díaz-Artiga, Adly Castañaza & Irma Sayury Pineda Fuentes

  3. Berkeley Air Monitoring Group, Berkeley, CA, USA

    Ricardo Piedrahita & Michael Johnson

  4. Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA

    Lisa Thompson

  5. Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA

    Maggie Clark, Jennifer Peel, Sarah Rajkumar & Bonnie Young

  6. Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA

    Ajay Pillarisetti & Kirk R. Smith

  7. College of Public Health, University of Georgia, Athens, GA, USA

    Katherine Kearns, Luke Naeher, Devan Campbell, Abigail Jones, Jacob Kremer & Davis Reardon

  8. Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA

    William Checkley

  9. Center for Global Non-Communicable Diseases, Johns Hopkins University, Baltimore, MD, USA

    William Checkley

  10. Sri Ramachandra Institute of Higher Education and Research, Chennai, India

    Vigneswari Aravindalochanan, Kalpana Balakrishnan, Sarada Garg, Krishnendu Mukhopadhyay, Naveen Puttaswamy, Sankar Sambandam & Gurusamy Thangavel

  11. School of Medicine, Johns Hopkins University, Baltimore, MD, USA

    Vanessa Burrowes, Dina Goodman, Shakir Hossen, Margaret Laws, Eric McCollum, Suzanne Simkovich, Lindsay Underhill & Kendra Williams

  12. Rollins School of Public Health, Emory University, Atlanta, GA, USA

    Howard Chang, Yunyun Chen, Lisa Elon, Penelope Howards, Shirin Jabbarzadeh, Azhar Nizam, Usha Ramakrishnan, Viviane Valdes, Amit Verma, Lance Waller & Megan Warnock

  13. A.B. PRISMA, San Miguel, Peru

    Marilú Chiang & Juan Gabriel Espinoza

  14. University of Oxford, Oxford, UK

    Rachel Craik & Aris Papageorghiou

  15. Seattle Children’s Hospital, Seattle, USA

    Mary Crocker

  16. Washington University in St. Louis, St. Louis, MO, USA

    Victor Davila-Roman, Lisa de las Fuentes, Rachel Meyers & Ashley Toenjes

  17. Eagle Research Center, Kigali, Rwanda

    Ephrem Dusabimana, Abidan Nambajimana, Florien Ndagijimana, Jean de Dieu Ntivuguruzwa & Jean Damascene Uwizeyimana

  18. Universidad Peruana Cayetano Heredia, Lima, Peru

    Stella Hartinger

  19. Johns Hopkins Bloomburg School of Public Health, Johns Hopkins University, Baltimore, MD, USA

    Steven Harvey

  20. Freie Universitat Berlin, Berlin, Germany

    Mayari Hengstermann

  21. Johns Hopkins University, Baltimore, MD, USA

    Phabiola Herrera

  22. T.H. Chan School of Public Health, Harvard University, Boston, MA, USA

    Lindsay Jaacks

  23. London School of Hygiene and Tropical Medicine, London, UK

    Fiona Majorin, Ghislaine Rosa & Zoe Sakas

  24. School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru

    J. Jaime Miranda

  25. Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA

    Lawrence Moulton

  26. Global LPG Partnership, New York, NY, USA

    Elisa Puzzolo

  27. Fogarty International Center, National Institutes of Health, Bethesda, MD, USA

    Ashlinn Quinn & Joshua Rosenthal

Authors
  1. Jiawen Liao
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  2. John P. McCracken
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  3. Ricardo Piedrahita
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  4. Lisa Thompson
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  5. Erick Mollinedo
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  6. Eduardo Canuz
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  7. Oscar De Léon
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  8. Anaité Díaz-Artiga
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  9. Michael Johnson
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  10. Maggie Clark
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  11. Ajay Pillarisetti
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  12. Katherine Kearns
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  13. Luke Naeher
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  14. Kyle Steenland
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  15. William Checkley
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  16. Jennifer Peel
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  17. Thomas F. Clasen
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Consortia

HAPIN investigators

  • Vigneswari Aravindalochanan
  • , Kalpana Balakrishnan
  • , Dana Boyd Barr
  • , Vanessa Burrowes
  • , Devan Campbell
  • , Julia McPeek Campbell
  • , Adly Castañaza
  • , Howard Chang
  • , Yunyun Chen
  • , Marilú Chiang
  • , Rachel Craik
  • , Mary Crocker
  • , Victor Davila-Roman
  • , Lisa de las Fuentes
  • , Ephrem Dusabimana
  • , Lisa Elon
  • , Juan Gabriel Espinoza
  • , Irma Sayury Pineda Fuentes
  • , Sarada Garg
  • , Dina Goodman
  • , Savannah Gupton
  • , Stella Hartinger
  • , Steven Harvey
  • , Mayari Hengstermann
  • , Phabiola Herrera
  • , Shakir Hossen
  • , Penelope Howards
  • , Lindsay Jaacks
  • , Shirin Jabbarzadeh
  • , Abigail Jones
  • , Miles Kirby
  • , Jacob Kremer
  • , Margaret Laws
  • , Amy Lovvorn
  • , Fiona Majorin
  • , Eric McCollum
  • , Rachel Meyers
  • , J. Jaime Miranda
  • , Lawrence Moulton
  • , Krishnendu Mukhopadhyay
  • , Abidan Nambajimana
  • , Florien Ndagijimana
  • , Azhar Nizam
  • , Jean de Dieu Ntivuguruzwa
  • , Aris Papageorghiou
  • , Naveen Puttaswamy
  • , Elisa Puzzolo
  • , Ashlinn Quinn
  • , Sarah Rajkumar
  • , Usha Ramakrishnan
  • , Davis Reardon
  • , Ghislaine Rosa
  • , Joshua Rosenthal
  • , P. Barry Ryan
  • , Zoe Sakas
  • , Sankar Sambandam
  • , Jeremy Sarnat
  • , Suzanne Simkovich
  • , Sheela Sinharoy
  • , Kirk R. Smith
  • , Damien Swearing
  • , Gurusamy Thangavel
  • , Ashley Toenjes
  • , Lindsay Underhill
  • , Jean Damascene Uwizeyimana
  • , Viviane Valdes
  • , Amit Verma
  • , Lance Waller
  • , Megan Warnock
  • , Kendra Williams
  • , Wenlu Ye
  •  & Bonnie Young

Corresponding author

Correspondence to Jiawen Liao.

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Liao, J., McCracken, J.P., Piedrahita, R. et al. The use of bluetooth low energy Beacon systems to estimate indirect personal exposure to household air pollution. J Expo Sci Environ Epidemiol 30, 990–1000 (2020). https://doi.org/10.1038/s41370-019-0172-z

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  • DOI: https://doi.org/10.1038/s41370-019-0172-z

Keywords

  • Household air pollution
  • Microenvironment
  • Fine particulate matters (PM2.5)
  • LPG Intervention
  • Indirect exposure

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